Ī qualitative study demonstrates that the struggle with weight management continues for some patients, while others have long-term beneficial effects of their surgery even 10 years later. Additionally, unhealthy eating habits and sedentary lifestyle, poor mental health, substance use, eating disorders, and the lack of nutritional follow-up may promote weight regain after bariatric surgery. Post-bariatric hypoglycemia has also been associated with weight regain. Anatomical failures related to surgical procedures, such as gastro-gastric fistula or dilated gastric pouch, may contribute to weight regain. Genetic factors, increases in gut hormones such as glucagon-like-peptide-1 (GLP-1) and peptide YY (PYY), and decreases in the production of ghrelin play an important role in appetite regulation and post-surgical weight outcomes. The exact prevalence of weight regain is difficult to estimate, since a definition for weight regain has not been established. from Sweden and the Netherlands report that 20 to 24% of patients have regained more than 15% of their body weight 5 years after RYGB or sleeve gastrectomy. The Longitudinal Assessment of Bariatric Surgery study (LABS) shows mean weight regain of about 4% after Roux-en-Y gastric bypass (RYGB) 3 to 7 years after surgery, while other studies e.g. Studies report large differences in the prevalence of weight regain in the bariatric population. Most patients regain some weight after their lowest weight has been reached. However, weight loss after bariatric surgery varies between individuals. Graphical abstractĬompared to lifestyle interventions, bariatric surgery is superior for long-term weight loss maintenance and improvement in overall health and quality of life. Social support, self-care, and behavioral strategies might facilitate long-term post-surgical weight management. Results indicate that internal and external circumstances such as psychosocial factors, changes in appetite, and physical and mental health problems may contribute to loss of control over weight. Weight regain after bariatric surgery was perceived to be an unexpected and difficult experience that induced hopelessness, discouragement, shame, and frustration. Social support, self-care, and behavioral strategies were perceived as facilitators for weight management (theme: reducing the burden of weight management). Nonetheless, participants experienced remaining benefits from the surgery, despite weight regain. Participants responded to weight regain with emotional distress, particularly with hopelessness, discouragement, shame, and frustration (theme: loss of control and focus). Participants experienced challenges such as eating in social settings, loneliness, family difficulties, increases in appetite, and physical and mental health problems, which distracted them from weight management. Participants had undergone gastric bypass surgery on average 10 years prior to study and regained 36% (range 12 to 71%) of their weight from their nadir. The transcribed recorded interview data was analyzed with thematic analysis. We recruited 16 adult participants (4 men, 12 women) at an obesity clinic in Stockholm, Sweden, 2018 to 2019, and performed semi-structured individual interviews. To increase the understanding of patients who experienced weight regain after bariatric surgery, we conducted a qualitative study. Bariatric surgery is a successful obesity treatment however, an estimated 1/5 of patients have regained more than 15% of their body weight 5 years post-surgery.
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